To what degree is palliative care integrated in guidelines and pathways for adult cancer patients in Europe: a systematic literature review

BMC Palliative Care

Research Article

Jeroen Hasselaar¹  Marlieke van der Eerden¹  Farina Hodiamont²  Lukas Radbruch²  Eduardo Garralda³  Carlos Centeno³  Johan Menten⁴  Karen Van Beek⁴  Naouma Siouta⁴  Agnes Csikos⁵  Ildiko Radvanyi⁵  Sheila Payne⁶  Nancy Preston⁶  Sean Hughes⁶ 

[1] Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany;Department of Palliative Medicine, University of Navarra Hospital, Navarra, Pamplona, Spain;Department of Radiation-Oncology and Palliative Medicine, University Hospital Gasthuisberg, Leuven, Belgium;Faculty of Medicine, Institute of Family Medicine, University of Pécs Medical School, Pécs, Hungary;International Observatory on End of Life Care, Division of Health Research Lancaster University, Lancaster, United Kingdom;

关键词: Delivery of Health Care;    Integrated;    Palliative care;    Medical oncology;    Systematic review;    Guidelines;    Pathways;   

DOI  :  10.1186/s12904-016-0100-0

 received in 2016-01-28, accepted in 2016-02-23,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPalliative Care (PC) aims to improve the quality of life for patients with cancer and their families and its benefits have been demonstrated by several studies. The objective of this systematic review is to assess the integration of PC in the content of guidelines/pathways of adult cancer patients in Europe.MethodsWe included studies of adult patients with cancer published from 01/01/1995 and 31/12/2013 in Europe in six languages. We searched nine electronic databases, hand-searched six journals and also performed citation tracking. Studies were ranked using Emanuel’s Integrated Palliative Care (IPC) criteria, a tool containing 11 domains to assess PC content in guidelines. Two reviewers screened the results and narrative synthesis has been employed.ResultsWe identified a total of 28,277 potentially relevant articles from which 637 were eligible for full-text screening. The final review included 60 guidelines and 14 pathways. Eighty percent (80 %) of the guidelines/pathways emphasize a holistic approach and 66 % focus on PC interventions aimed at reducing suffering. Fifty seven percent (57 %) did not discuss referral criteria for PC. Of all studies, five fulfilled at least 10/11 IPC criteria. Differences existed with regard to the referral criteria for bereavement care and the continuous adjustment of goals of care.ConclusionOverall, most of the identified guidelines/pathways highlighted the importance of the holistic approach of IPC. The studies that were found to fulfil at least 10/11 Emanuel’s IPC criteria could serve as benchmarks of IPC.

【 授权许可】

CC BY   
© Van Beek et al. 2016